美泊利单抗治疗重度哮喘及其相关合并症患者的真实疗效
2021/06/18
摘要
背景：重度哮喘患者常出现相关合并症，加重现有症状，使哮喘治疗复杂化。
目的：描述美泊利单抗在根据常见重叠合并症分层的重度哮喘患者中的真实疗效。
方法：本研究是一项针对来自MarketScan商业和医疗保险补充数据库中开始美泊利单抗治疗的哮喘患者的回顾性分析。符合条件的患者有≥1 项索赔（不包括诊断测试的索赔）)，且在12个月的指数前基线期间，诊断代码为 7 种合并症（特应性疾病、鼻息肉、慢性鼻窦炎、肥胖、呼吸道感染、慢性阻塞性肺病和抑郁/焦虑）中≥1 项的诊断代码；以此将患者分成7个非相互排斥的亚组。结果包括在12个月的基线和随访期内的哮喘急性加重和急性加重相关的医疗资源利用 (HCRU)。每位患者均以自身为对照。
结果：纳入639例患者，其中最常见的合并症是特应性疾病(73.2%)、呼吸道感染(55.6%)和慢性鼻窦炎(45.1%)。在所有7种合并症亚组中，由于亚组样本量较小，除鼻息肉亚组中需要住院的哮喘加重外，在随访期间与基线期间，加重期和需要住院治疗的加重期分别显著减少了38-55%和57-83%(P<0.05)。随访期间与基准期相比，口服糖皮质激素（OCS）的平均索赔次数显著减少，减少了29%-38%(P<0.001)；39%-47%的患者获得了≥50%的OCS剂量减少。与急性加重相关的HCRU也显著减少。
结论：美泊利单抗治疗为患者提供了真实世界的临床获益。
Real-world effectiveness of mepolizumab in patients with severe asthma and associated comorbidities
Thomas Casale, Nestor A Molfino, Jared Silver, Michael Bogart, Elizabeth Packnett, Donna McMorrow, Joanne Wu, Beth Hahn
Abstract
BACKGROUND:Patients with severe asthma frequently have associated comorbidities, which can compound existing symptoms, complicating asthma management.
OBJECTIVE:To describe mepolizumab's real-world effectiveness in patients with severe asthma stratified by common overlapping comorbidities.
METHODS:This was a retrospective analysis of patients with asthma from the MarketScan Commercial and Medicare Supplemental Database initiating mepolizumab treatment (index date). Eligible patients had ≥1 claim (excluding claims for diagnostic tests) with a diagnosis code for ≥1 of seven comorbidities (atopic disease, nasal polyps, chronic sinusitis, obesity, respiratory infections, chronic obstructive pulmonary disease, and depression/anxiety) during the 12-month pre-index baseline period; these were used to stratify patients into seven nonmutually exclusive subgroups. Outcomes included asthma exacerbations and exacerbation-related healthcare resource utilization (HCRU) during the 12-month baseline and follow-up periods. Each patient acted as their own control.
RESULTS:Of the 639 patients included, the most common comorbidities were atopic diseases (73.2%), respiratory infections (55.6%), and chronic sinusitis (45.1%). Across all seven comorbidity subgroups, there were significant (P <0.05) reductions of 38-55% and 57-83% in exacerbations and exacerbations requiring hospitalization, respectively, during the follow-up versus baseline period, except for exacerbations requiring hospitalization in the nasal polyps subgroup, due to the small subgroup sample size. During the follow-up versus baseline periods, mean number of OCS claims was significantly (P <0.001) reduced by 29-38%; 39-47% of patients achieved ≥50% OCS dose reduction. Significant reductions in exacerbation-related HCRU were also observed.
CONCLUSION:Mepolizumab treatment provided real-world clinical benefits in patients.
背景：重度哮喘患者常出现相关合并症，加重现有症状，使哮喘治疗复杂化。
目的：描述美泊利单抗在根据常见重叠合并症分层的重度哮喘患者中的真实疗效。
方法：本研究是一项针对来自MarketScan商业和医疗保险补充数据库中开始美泊利单抗治疗的哮喘患者的回顾性分析。符合条件的患者有≥1 项索赔（不包括诊断测试的索赔）)，且在12个月的指数前基线期间，诊断代码为 7 种合并症（特应性疾病、鼻息肉、慢性鼻窦炎、肥胖、呼吸道感染、慢性阻塞性肺病和抑郁/焦虑）中≥1 项的诊断代码；以此将患者分成7个非相互排斥的亚组。结果包括在12个月的基线和随访期内的哮喘急性加重和急性加重相关的医疗资源利用 (HCRU)。每位患者均以自身为对照。
结果：纳入639例患者，其中最常见的合并症是特应性疾病(73.2%)、呼吸道感染(55.6%)和慢性鼻窦炎(45.1%)。在所有7种合并症亚组中，由于亚组样本量较小，除鼻息肉亚组中需要住院的哮喘加重外，在随访期间与基线期间，加重期和需要住院治疗的加重期分别显著减少了38-55%和57-83%(P<0.05)。随访期间与基准期相比，口服糖皮质激素（OCS）的平均索赔次数显著减少，减少了29%-38%(P<0.001)；39%-47%的患者获得了≥50%的OCS剂量减少。与急性加重相关的HCRU也显著减少。
结论：美泊利单抗治疗为患者提供了真实世界的临床获益。
(中日友好医院呼吸与危重症医学科 王静茹 摘译 林江涛 审校)
(Ann Allergy Asthma Immunol. 2021 May 23;S1081-1206(21)00382-3.doi: 10.1016/j.anai.2021.05.021.)
(Ann Allergy Asthma Immunol. 2021 May 23;S1081-1206(21)00382-3.doi: 10.1016/j.anai.2021.05.021.)
Real-world effectiveness of mepolizumab in patients with severe asthma and associated comorbidities
Thomas Casale, Nestor A Molfino, Jared Silver, Michael Bogart, Elizabeth Packnett, Donna McMorrow, Joanne Wu, Beth Hahn
Abstract
BACKGROUND:Patients with severe asthma frequently have associated comorbidities, which can compound existing symptoms, complicating asthma management.
OBJECTIVE:To describe mepolizumab's real-world effectiveness in patients with severe asthma stratified by common overlapping comorbidities.
METHODS:This was a retrospective analysis of patients with asthma from the MarketScan Commercial and Medicare Supplemental Database initiating mepolizumab treatment (index date). Eligible patients had ≥1 claim (excluding claims for diagnostic tests) with a diagnosis code for ≥1 of seven comorbidities (atopic disease, nasal polyps, chronic sinusitis, obesity, respiratory infections, chronic obstructive pulmonary disease, and depression/anxiety) during the 12-month pre-index baseline period; these were used to stratify patients into seven nonmutually exclusive subgroups. Outcomes included asthma exacerbations and exacerbation-related healthcare resource utilization (HCRU) during the 12-month baseline and follow-up periods. Each patient acted as their own control.
RESULTS:Of the 639 patients included, the most common comorbidities were atopic diseases (73.2%), respiratory infections (55.6%), and chronic sinusitis (45.1%). Across all seven comorbidity subgroups, there were significant (P <0.05) reductions of 38-55% and 57-83% in exacerbations and exacerbations requiring hospitalization, respectively, during the follow-up versus baseline period, except for exacerbations requiring hospitalization in the nasal polyps subgroup, due to the small subgroup sample size. During the follow-up versus baseline periods, mean number of OCS claims was significantly (P <0.001) reduced by 29-38%; 39-47% of patients achieved ≥50% OCS dose reduction. Significant reductions in exacerbation-related HCRU were also observed.
CONCLUSION:Mepolizumab treatment provided real-world clinical benefits in patients.
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中重度哮喘患者发作病史对dupilumab临床疗效的影响
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重度哮喘支气管热成形术后气道重塑的长期调节
